You are here

Home » Content

Deneysel Peritonit Modelinde Oktreotid Ultrafiltrasyon Yetmezliğini Engelleyebilir

Octreotide May Prevent Ultrafiltration Failure in Experimental Peritonitis Model

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
DOI 10.5262/tndt.2011.1001.08

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIV E: Ultrafiltration (UF) failure is a frequent complication of peritoneal dialysis peritonitis. Octreotide (OCT) has antiproliferative effects on many cells. The present study aimed to investigate the effect of OCT (administered locally or systemically) on peritoneal alterations induced by bacterial peritonitis. MA TERIAL and M ETHODS: Forty-two non-uremic female rats, weighing 160-180 g, were divided into four groups receiving no treatment (Control, n=12), peritonitis group (received 1.5 ml suspension of E. coli (107 CFU/ml) (E.coli, n=12)), and two treatment groups that received E.coli + 50 mcg/kg OCT (local OCT, n=10) intraperitoneally (IP) and (systemic OCT, n=8) subcutaneously. After six hours, a one-hour PET was performed with 20 ml 3.86% PD solution; the D1/D0 glucose, UF volume, dialysate cell count, dialysate protein, TGF-β1, VEGF and IL-1β levels were determined. RESUL TS: Exposure to E. coli causes bacterial peritonitis with increase in peritoneal permeability leading to rapid dissipation of the glucose gradient and UF failure. IP administration of OCT led to attenuation of UF failure by inhibiting local TGF-β1 production. Both local and systemic administration of OCT decreased dialysate cell count and maintained UF. CONCLU SION: Local or systemic OCT administration may help to preserve peritoneal viability and UF capacity by inhibiting cell infiltration to the peritoneal cavity and decreasing dialysate cell count during peritonitis. In the long-term, it can decrease peritoneal fibrosis.
Bookmark/Search this post with
Abstract (Original Language): 
AMA Ç: Ultrafiltrasyon (UF) yetersizliği periton diyalizi peritonitinde sık rastlanan bir komplikasyondur. Oktreotid (OCT)’ in birçok hücre üzerinde antiproliferatif etkileri olduğu gösterilmiştir. Bu çalışmada amacımız, bakteriyel peritonitin neden olduğu periton değişiklikleri üzerine sistemik veya bölgesel olarak uygulanan OCT’ nin etkilerini incelemektir. GEREÇ ve YÖN TEML ER: Kırk iki tane üremik olmayan 160-180 gr ağırlığında dişi sıçan; Tedavi verilmeyen grup (Kontrol, n=12), Peritonit grubu (E.coli, n=12) 1,5 ml E. coli suspansiyonu (107 CFU/ml), Tedavi grupları 1,5 ml E. coli suspansiyonu (107 CFU/ml)+ 50mcg/kg OCT periton içine (Bölgesel OCT, n=10) ve deri altına (Sistemik OCT, n=8) uygulanmak suretiyle dört gruba ayrıldı. Altı saat sonunda, %3,86 glukoz içeren PD solusyonu ile bir saatlik periton eşitlenme testi yapıldı. D1/D0 glukoz, UF hacmi, diyalizat hücre sayısı, diyalizat protein, TGF-β1, VEGF ve IL-β düzeyleri ölçüldü. BUL GULA R: E. coli maruziyeti bakteriyel peritonite yol açarak periton geçirgenliğini artırıp glukoz gradiyentinde azalma ve UF yetmezliğine neden oldu. Periton içine uygulanan OCT bölgesel TGF-β1 inhibisyonu ile UF yetmezliğini azaltmıştır. Bölgesel ve sistemik olarak uygulanan OCT diyalizat hücre sayısını azaltmış ve UF’ yi korumuştur. SONU Ç: Bölgesel ve sistemik olarak uygulanan OCT peritonit sırasında diyalizat hücre sayısını azaltarak, periton boşluğuna hüce infiltrasyonunu inhibe etmek suretiyle UF kapasitesini ve periton canlılığını korumaya yardım ediyor olabilir. Uzun dönemde peritoneal fibrozisi azaltabilir.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_20_pp_46-52.pdf
  • 1
46-52
  • Turkish

REFERENCES

References: 

1. Krediet RT: The peritoneal membrane in chronic peritoneal dialysis.
Kidney Int 1999; 55: 341-356
2. Tzamaloukas AH: Inadequacy of dialysis and infectious
complications of continuous ambulatory peritoneal dialysis (CAPD):
Diagnosis, management and prevention. AKF Nephrol 1991; 8:29
3. Mujais S, Nolph K, Gokal R, Blake P, Burkart J, Coles G, Kawaguchi
Y, Kawanishi H, Korbet S, Krediet R, Lindholm B, Oreopoulos D,
Rippe B, Selgas R: Evaluation and management of ultrafiltration
problems in peritoneal dialysis. International Society for Peritoneal
Dialysis Ad Hoc Committee on Ultrafiltration Management in
Peritoneal Dialysis. Perit Dial Int 2000; 20 Suppl 4: S5-21
4. Pollock CA, Ibels LS, Hallett MD: Loss of ultrafiltration in
continuous ambulatory peritoneal dialysis (CAPD). Perit Dial Int
1989; 9: 107
5. Margetts PJ, Churchill DN: Acquired ultrafiltration dysfunction in
peritoneal dialysis patients. J Am Soc Nephrol 2002; 13: 2787
6. Stegmayr BG: Beta-blockers may cause ultrafiltration failure in
peritoneal dialysis patients. Perit Dial Int 1997; 17: 541
7. Honda K, Nitta K, Horita S, Yumura W, Nihei H: Morphological
changes in the peritoneal vasculature of patients on CAPD with
ultrafiltration failure. Nephron 1996; 72: 171-176
8. Rubin J, Herrera GA, Collins D: An autopsy study of the peritoneal
cavity from patients on continuous ambulatory peritoneal dialysis.
Am J Kidney Dis 1991; 18: 97-102
9. Fracasso A, Baggio B, Ossi E, Prete DD, Bonfante L, Bazzato
G, Gambaro G: Glycosaminoglycans prevent the functional and
morphological peritoneal derangement in an experimental model of
peritoneal fibrosis. Am J Kidney Dis 1999; 33: 105-110
10. Honda K, Nitta K, Horita S, Yumura W, Nihei H, Nagai R, Ikeda
K, Horiuchi S: Accumulation of advanced glycation end products
in the peritoneal vasculature of continuous ambulatory peritoneal
dialysis patients with low ultra-filtration. Nephrol Dial Transplant
1999; 14: 1541-1549
51
Hür E ve ark: Peritonit Modelinde Oktreotid Tedavisi Türk N efroloji D iyaliz ve Transplantasyon D ergisi
Turkish Nephrology, Dialysis and Transplantation Journal
Turk Neph Dial Transpl 2011; 20 (1): 46-52
28. Mori Y, Matsuo S, Sutoh H, Toriyama T, Kawahara H, Hotta N:
A case of a dialysis patient with sclerosing peritonitis successfully
treated with corticosteroid therapy alone. Am J Kidney Dis 1997;
30: 275
29. Allaria PM, Giangrande A, Gandini E, Pisoni IB: Continuous
ambulatory peritoneal dialysis and sclerosing encapsulating
peritonitis: Tamoxifen as a new therapeutic agent? J Nephrol 1999;
12(6):395-397
30. Duman S, Şen S, Duman C, Arda B, Töz H, Ok E, Akçiçek F,
Başçı A: The effects of tamoxifen and cyclosporine on dialysate
cytokine profile in hypertonic PD solution induced rats. Nephrol
Dial Transplant 2003; vol 18,Suppl 4; 776 (Abst)
31. Duman S, Şen S, Duman C, Oreopoulos D.G: Effect of valsartan
versus lisinopril on peritoneal Sclerosis In Rats. Int J Artif Organs
2005; 28(2): 156-163
32. Duman S, Şen S, Sözmen E.Y, Oreopoulos DG: Atorvastatin
improves peritoneal sclerosis induced by hypertonic Pd solution in
rats. Int J Artif Organs 2005; 28(2): 170-176
33. Duman S, Gunal AI, Sen S, Asci G, Ozkahya M, Terzioglu E,
Akcicek F, Atabay G: Does enalapril prevent peritoneal fibrosis
induced by hypertonic (3.86%) peritoneal dialysis solution? Perit
Dial Int 2001; 21(2): 219-224
34. Duman S, Şen S, Duman C, Aşcı G, Basci A, Akcicek F: Improvement
of peritoneal alterations induced by hipertonic PD solutions by ACE
inhibitors and by AR blockers. Nephrol Dial Transplant 2003 vol
18,Suppl 4; s: 474 (Abst)
35. Duman S, Şen S, Özkahya M, Başçı A, Akçiçek F: Does Colchicine
ameliorate peritoneal alterations induced by hypertonic pd solution?
V. EUROPD European Peritoneal Dialysis Meeting, Brussel,
Peritoneal Dialysis International 2002; 22(1): 113
36. Duman S, Wieczorowska-Tobis K, Styszynski A, Kwiatkowska
B, Breborowicz A, Oreopoulos DG: Intraperitoneal enalapril
ameliorates morphologic changes induced by hypertonic peritoneal
dialysis solutions in rat peritoneum. Adv Perit Dial 2004; 20:
31-36
37. Gunal AI, Duman S, Sen S, Unsal A, Terzioglu E, Akcicek F,
Basci A: By reducing TGF beta 1, octreotide lessens the peritoneal
derangements induced by a high glucose solution. J Nephrol 2001;
14(3): 184-189
38. Gunal A, Celiker H, Akpolat N, Ustundag B, Duman S, Akcicek
F: By reducing production of vascular endothelial growth factor
octreotide improves the peritoneal vascular alterations induced by
hypertonic peritoneal dialysis solution. Perit Dial Int 2002; 22(3):
301-306
39. Nolph and Gokal’s Textbook of Peritoneal Dialysis. (3rd edi).
Columbia: Springer, 2009; 15-16
40. Bosscha K, Nieuwenhuijs VB, Gooszen AW, van Duijvenbode-
Beumer H, Visser MR, Verweij WR, Akkermans LM: A standardised
and reproducible model of intraabdominal infection and abscess
formation in rats. Eur J Surg 2000; 166(12): 963-967
41. Zemel D, Krediet RT, Koomen GCM, Kortekaas WM, Geertzen
HG, ten Berge RJ: Interleukin-8 during peritonitis in patients treated
with CAPD; an in vivo model of acute inflammation. Nephrol Dial
Transplant 1994; 9: 169-174
11. Krediet RT, Zuyderhoudt FM Krediet R, Mujais S: Use of icodextrin
in high transport ultrafiltration failure. Kidney Int 2002; (81):
S53-61
12. Boeschoten EW, Arisz L: Alterations in the peritoneal transport
of water and solutes during peritonitis in continuous ambulatory
peritoneal dialysis patients. Eur J Clin Invest 1987; 17: 43-52
13. Douma CE, de Waart DR, Struijk DG, Krediet RT: Are phospholipase
A2 and nitric oxide involved in the alterations in peritoneal transport
during CAPD peritonitis? J Lab Clin Med 1998; 132: 329-340
14. Pannekeet MM, Imholz AL, Struijk DG, Koomen GC, Langedijk
MJ, Schouten N, de Waart R, Hiralall J, Krediet RT: The standard
peritoneal permeability analysis: A tool for the assessment of
peritoneal permeability characteristics in CAPD patients. Kidney
Int 1995; 48: 866-875
15. Chaimovitz C: Peritoneal dialysis. Kidney Int 1994; 45: 1226-1240
16. Dobbie JW: Pathogenesis of peritoneal fibrosing syndromes
(sclerosing peritonitis) in peritoneal dialysis. Perit Dial Int 1992;
12: 14-27
17. Border WA, Noble NA: TGF β in kidney fibrosis: A target for gene
therapy. Kidney Int 1997; 51: 1388-1396
18. Peters H, Border WA, Noble NA: Targeting TGF β overexpression
in renal disease: Maximizing the antifibrotic action of angiotensin II
blockade. Kidney Int 1998;54: 1570-1580
19. Duman S: The renin-angiotensin system and peritoneal dialysis.
Perit Dial Int 2004; 24(1): 5-9
20. Falconi M, Vesentini S, Bassi C: Exocrine pancreatic response to
SMS 2001-995. Ital J Gastroenterol 1991; 23: 3 p: 156
21. Fort E, Sauterau D, Silvain C, Ingrand P, Pillegand B, Beauchant
M: A randomized trial of glypressin plus transdermal nitroglycerin
versus octreotide in the control of acute variceal hemorrhage. Europ
J Gastroenterol Hepatol 1991; vol 3 suppl 1: 25
22. Vinciguerra L, Contillo A, Bussci R, Parente A: Efficacy of
octreotide+ 5 fluorouracil therapy in one patient with carcinoid
syndrome. J Endoc Invest 1990; vol 13, suppl 1: 235
23. Brunani A, Crespi C, De Martin M, Dubini A, Piolini M, Cavagnini
F: Four year treatment with a long acting somatostatin analogue in
a patient with Verner-Morrison syndrome. J Endoc Invest 1991; 14:
685-689
24. Annibale B, Corleto V, Gamboni G: Efficacy of somatostatin analog
(SMS 201-995) on exocrine end endocrine gastric cells in Zollinger-
Ellison syndrome (ZES) and antral G cell hyperfunction (AGHC).
Europ J Gastroenterol Hepatol 1991; vol 3 suppl 1:34
25. Amoric JC, Dreno B, Mourreaux P, Litoux P: Syndrome du
glucagonoma. Interet de L’association dacarbazine-somatostatine.
Sem Hop Paris 1991; 67: 1069-1072
26. Cello JP, Grendell JH, Basuk P Simon D, Weiss L, Wittner M, Rood
RP, Wilcox CM, Forsmark CE, Read AE: Effect of octreotide on
refractory AIDS-associated diarrhoea: A prospective, multicenter
clinical trial. Ann Intern Med 1991; 115: 705-710
27. Martins LS, Rodrigues AS, Cabrita AN, Guimaraes S: Sclerosing
encapsulating peritonitis: A case successfully treated with
immunosuppression. Perit Dial Int 1999; 19: 478
Hür E ve ark: Peritonit Modelinde Oktreotid Tedavisi
Turk Neph Dial Transpl 2011; 20 (1): 46-52 52
Türk N efroloji D iyaliz ve Transplantasyon D ergisi
Turkish Nephrology, Dialysis and Transplantation Journal
42. Tekstra J, Visser CE, Tuk CW Brouwer-Steenbergen JJ, Burger CW,
Krediet RT, Beelen RH: Identification of the major chemokines
that regulate cell influxes in peritoneal dialysis patients. J Am Soc
Nephrol 1996; 7: 2379-2384
43. Lai KN, Lai KB, Lam CW, Chan TM, Li FK, Leung JC: Changes
of cytokine profiles during peritonitis in patients on continuous
ambulatory peritoneal dialysis. Am J Kidney Dis 2000; 35:
644-652
44. Wang T, Cheng HH, Heimbürger O, Waniewski J, Bergström
J, Lindholm B: Effect of peritonitis on peritoneal transport
characteristics: Glucose solution versus polyglucose solution.
Kidney Int 2000; 57: 1704-1712
45. Rodela H, Yuan ZY, Hay JB, Oreopoulos DG, Johnston MG :
Reduced lymphatic drainage of dialysate from the peritoneal cavity
during acute peritonitis in sheep. Perit Dial Int 1996; 16: 163-171
46. Carlsson O, Rippe B: Peritoneal lymphatic absorption and solute
exchange during zymosan-induced peritonitis in the rat. Am J
Physiol 1999; 277: H1107-H1112
47. Breborowicz A, Wieczorowska-Tobis K, Korybalska K, Polubinska
A, Radkowski M, Oreopoulos DG: The effect of a nitric oxide
inhibitor (L-NAME) on peritoneal transport during dialysis in rats.
Perit Dial Int 1998; 18: 188-192
48. Zemel D, Koomen GCM, Hart AAM, ten Berge IJ, Struijk DG,
Krediet RT: Relationship of TNF, interleukin-6 and prostaglandins
to peritoneal permeability for macromolecules during longitudinal
follow-up of peritonitis in continuous ambulatory peritoneal
dialysis. J Lab Clin Med 1993; 122: 686-696
49. Zemel D, Struijk DG, Dinkla C, Stolk LM, ten Berge IJ, Krediet RT:
Effects of intraperitoneal cyclooxygenase inhibition on inflammatory
mediators in dialysate and peritoneal membrane characteristics
during peritonitis in continuous ambulatory peritoneal dialysis. J
Lab Clin Med 1995; 126: 204-215
50. Peng H, Cheung AK, Reimer LG, Kamerath CD, Leypoldt JK:
Effect of indomethacin on peritoneal protein loss in a rabbit model
of peritonitis. Kidney Int 2001; 59: 44-51
51. Davies M, Stylianou E, Yung S, Thomas GJ, Coles GA, Williams
JD: Proteoglycans of CAPD-dialysate fluid and mesothelium. Contr
Nephrol 1990; 85: 134-141
52. Lipkin GW, Forbes MA, Cooper EH, Turney JH: Hyaluronic acid
metabolism and its clinical significance in patients treated by
continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant
1993; 8: 357-360
53. Yung S, Coles GA, Williams JD, Davies M: The source and possible
significance of hyaluronan in the peritoneal cavity. Kidney Int 1994;
46: 527-533
54. Pannekeet MM, Zemel D, Koomen GCM, Struijk DG, Krediet RT:
Dialysate markers of peritoneal tissue during peritonitis and stable
CAPD. Perit Dial Int 1995; 15: 217-225
55. Yung S, Coles GA, Davies M: IL-1, a major stimulator of hyaluronan
synthesis in vivo of human peritoneal mesothelial cells: Relevance
to peritonitis in CAPD. Kidney Int 1996; 50: 1337-1343
56. Lai KN, Szeto CC, Lai KB, Lam CW, Chan DT, Leung JC: Increased
production of hyaluronan by peritoneal cells and its significance in
patients on CAPD. Am J Kidney Dis 1999; 33: 318-324
57. Wang T, Cheng H, Heimburger O, Waniewski J, Bergström J,
Lindholm B: Hyaluronan prevents the decreased net ultrafiltration
caused by increased peritoneal dialysate fill volume. Kidney Int
1998; 53: 496-502
58. Polubinska A, Pawlaczyk K, Kuzlan-Pawlaczyk M, Wieczorowska-
Tobis K, Chen C, Moberly JB, Martis L, Breborowicz A,
Oreopoulos DG: Dialysis solution containing hyaluronan: Effect on
peritoneal permeability and inflammation in rats. Kidney Int 2000;
57:1182-1189
59. Breborowicz A, Polubinska A, Moberly J, Ogle K, Martis L,
Oreopoulos D: Hyaluronan modifies inflammatory response and
peritoneal permeability during peritonitis in rats. Am J Kidney Dis
2001; 37: 594-600
60. Fussholler A, zur Nieden S, Grabensee B, Plum J: Peritoneal fluid
and solute transport: Influence of treatment time, peritoneal dialysis
modality, and peritonitis incidence. J Am Soc Nephrol 2002; 13:
1055-1060
61. Wong TY, Szeto CC, Lai KB, Lam CW, Lai KN, Li PK: Longitudinal
study of peritoneal membrane function in continuous ambulatory
peritoneal dialysis: Relationship with peritonitis and fibrosing
factors. Perit Dial Int 2000; 20: 679-685
62. Davies SJ, Bryan J, Phillips L, Russel GI: Longitudinal changes in
peritoneal kinetics: The effects of peritoneal dialysis and peritonitis.
Nephrol Dial Transplant 1996; 11: 498-506
63. Selgas R, Fernandez-Reyes M-J, Bosque E, Bajo MA, Borrego
F, Jimenez C, Del Peso G, De Alvaro F: Functional longevity of
the human peritoneum: How long is continuous peritoneal dialysis
possible? Results of a prospective medium long-term study. Am J
Kidney Dis 1994; 23: 64-73
64. Fort J, Oberti F, Pilette C, Veal N, Gallois Y, Douay O, Rousselet
MC, Rosenbaum J, Cales P: Antifibrotic and hemodynamic effects
of the early and chronic administration of octreotide in two models
of liver fibrosis in rats. Hepatology 1998; 28(6): 1525-1531
65. Wang J, Zheng H, Hauer-Jensen M: Influence of short-term octreotide
administration on chronic tissue injury, transforming growth factor
beta (TGF-beta) overexpression, and collagen accumulation in
irradiated rat intestine. J Pharmacol Exp Ther 2001; 297(1): 35-42
66. Mishin I, Ghidirim G, Vozian M: Acute spontaneous chylous
peritonitis: Report of a case. J Gastrointestin Liver Dis 2010; 19(3):
333-335
67. Lee PH, Lin CL, Lai PC, Yang CW: Octreotide therapy for chylous
ascites in a chronic dialysis patient. Nephrology (Carlton) 2005;
10(4): 344-347

Thank you for copying data from http://www.arastirmax.com